Richard is now 45 days sober, which is awesome, but when he comes back to Seattle Grace he doesn't find his job waiting for him quite like he expected -- Derek reminds him that his being reinstated as Chief is dependent on board approval (which seems to not yet be there) and in the meantime, offers him a position as an attending surgeon. Richard is understandably miffed by the offer, but does agree to come back and give a lecture as part of the lecture series that Derek has revived. He takes us back in time to when he and Ellis were residents with a particularly baffling case. In between their own bouts in the on-call room they realize that their resident might have what will come to be known as AIDS, though in 1982 they didn't even have that name for the disease, much less a test for it. The patient himself won't even be honest with them until things get really bad, but they manage to convince him to let them operate and they manage to prolong his life for a few extra months. When toasting to the guy's memory, Ellis gives Richard his first taste of vodka, and between that and admitting to her that he's not going to leave Adele, we see how he started down his own unfortunate life's path.
Bailey is also chosen to give a lecture, and she talks about a patient who came in with abdominal pain that can't be explained. Her resident has quite the attitude and clearly hates Miranda ("Mandy") and her already awesome brain, and they butt heads during the months in which the patient has various surgeries that all turn up nothing. For her first solo surgery, Bailey even takes out the woman's appendix -- only to discover that it's healthy and not causing any of her problems. Finally, after looking at her patient's whole history, not just her symptoms, Bailey figures out the problem and gives her resident a massive dressing down when telling her what is really wrong. Richard calls her to his office and then has her pretend to look upset while he pretends to yell at her so that her resident can save face, but really he tells her what an awesome surgeon she's going to be one day.
Callie is the third lecturer of the day, and after some ridiculous bullshit about her having massive stage fright, which totally doesn't fit with what we know about her, Alex and Arizona help her tell her story of a patient with horribly misshapen legs, who she promises will walk again. Richard thinks she's reckless for telling the guy so, but she decides to prove him wrong and when Alex comes to her looking to help, she brings him on the case. She thinks he's the intern who performed heart surgery in the elevator, and Alex decides to play along with that and not correct her. After the first surgery has to be cut short, they need to be convinced to continue by the patient himself to continue their efforts, and in his surgery his heart nearly gives out. Callie tells Alex to do what he did in the elevator to help him out and Alex has to admit that he lied and he totally wasn't the one who did that, but she convinces him that he can do it now and they save the guy. After a few more procedures, they help him to walk and celebrate... by hooking up!! Alex! Callie! That I didn't expect. (And clearly neither did Arizona.)
By the end of the day the doctors have all seemed to learn something about learning from each other and not giving up on the tough cases, and when Richard ends his speech with a shortened Hippocratic Oath, they all give him a standing ovation. Before he leaves that night, Derek comes and tells Richard that the job offer still stands, and Richard says, if only to himself just yet, that we'll see.
"I've seen a lot of surgery residents come and go in my time, and they're all addicted... to surgery." This week's voiceover -- more commanding than we've heard in a long time -- is delivered by Richard, and he's better at it than all of the recent guest voiceovers. And he's way, WAY better at it than Meredith. "It comes before food, before sleep, it becomes the most important thing. The only thing." Bailey is in a fuchsia suit primping in front of the mirror, and Dr. Warren comes up and watches her with a smile. She freezes when she notices him and then orders him away, but he just laughs and tells her she looks nice. She orders him away again and he listens, but then she allows herself a happy little smile once she's alone.
"What they don't know is living on that high can eat them alive." Callie has food poisoning? Stomach flu? It must be something horrible as Arizona is brushing her hair while she sits to the toilet, crying. Oh wait no -- she's terrified of public speaking and hates Derek for making her speak in front of a giant room full of people. Arizona tries to assure her (a bit weary, having clearly been doing this a while -- I guess she's over needing Callie to be sexy and perfect, the stupidest forced character trait all season, at least until now) that all she needs to do is talk about being a great surgeon. This doesn't seem to help, and when she thinks about going on stage Callie leans in to puke again.
"Some make it through, they come out on the other side. They survive with their sanity intact. They become better doctors and stronger people. I didn't. I broke. I didn't kill anybody, and I give thanks for that every day, but I hurt people. And scared the hell out of myself. I am 45 days sober today. I am Richard, and I am a grateful and recovering alcoholic." The people listening all clap for him; we've been hearing him speak at an AA meeting and really sound more in control than he has in quite a while.
He then goes to meet with Derek, and is not hiding his displeasure at the way things are going. He reminds Derek that he was told that if he went to rehab his job would be waiting but Derek, acting like it wasn't he himself who used this as a selling point for rehab, reminds him of Jennings' "Pending board approval" catch. He says he's sorry, not sounding terribly like it, and then tells Richard that he's been authorized to offer him a job as an attending general surgeon. While Derek isn't my favorite person, and I think he's hiding behind the board here a bit -- isn't 45 days kind of soon to jump back in to running a hospital? I would think that would be something Derek could point out, rather than just mentioning that the board might reconsider in a few months. Regardless, Richard is ticked and turns down the offer to work under his former employee before walking out.
Derek thinks a moment and then runs after him, saying that it's Lecture Day and he has an open spot. Richard sounds happily surprised to hear that Derek brought this back, and Derek takes advantage of the mood and offers him a chance to leave with dignity, giving one last lecture before he goes.
Derek then greets everyone assembled in the lecture hall, but while he sounds excited, no one else seems to be; Mere and Cristina are practicing some kind of sutures or knots with string wrapped around their legs. Derek reminds everyone that it is a teaching hospital and that they will learn from other doctors' cases, but no one seems to really believe him when he says this will be good. There's lukewarm applause for Bailey, who walks on stage in her pink suit, notices that Mere and Cristina aren't paying attention, and proceeds to bean Cristina in the head with a chocolate to get her attention. She tells the girls that if she has to talk, they have to listen, and then bribes everyone with chocolate for answering questions correctly. Those who dose off will get a sweet to the forehead and Bailey touts her good aim before launching into a story from 2003, when she was starting her intern year.
A blonde doctor introduces a patient named Alicia who is having unexplained abdominal pain three months after having her ovaries removed. When Richard asks what the workup showed, a quiet voice in the back of the crowd of doctors mumbles the answer, and after this happening a couple of times Richard asks who it is and the crowd parts to show Bailey, with purple-rimmed glasses and her hair in long braids. He seems impressed by her knowing the answer while the blonde resident is ticked to have someone upstage her. Richard promises Alicia they will get to the bottom of her pain and has the doctors prep for surgery and after they all file out, Blondie calls after Bailey who puts out her hand and introduces herself as "Mandy." Blondie asks if that is what she's going with, adding that her parents really wanted her to work for it. Seriously, it's super heavy-handed emphasis on the nickname, which obviously we know doesn't suit her at all, but no one says that about a relatively common name when they meet someone whether they like them or not. She tells Bailey to draw Alicia's blood and when Bailey tries to ask a question, Blondie pounces and insults her, reminding her that she's at the bottom of the surgical food chain while Blondie is a big-time third year resident. She orders Bailey angrily to draw the blood and stalks off.
Having been woken up by Bailey, Meredith is paying attention and notices that Callie is shaking. Cristina realizes that she's doing her "pee dance" and indeed she's bent over her laptop, arse to the crowd, tapping her foot and wiggling as she tries to pull up her presentation. First she pulls up a picture of her and Arizona, but after a moment she pulls up a picture of a guy with one leg making a c-curve and his foot turned sole-up to the camera. That stops the giggling from the earlier photo but then Callie starts mumbling quietly while reading off notecards like she just learned how to read out loud last week. People start hollering that they can't hear her, so she speaks up just a tiny bit and says that in her third year she had a patient named Sunder, a 28-year-old grad student.
Mercifully, we are then taken back to that time, showing Callie as her usually confident self and with her hair piled up on her head like when we first met her. Alex paged her to see a patient but she's totally unimpressed by the eager intern and not interested in putting him on any case. Alex wheedles that it's been hard since the elevator and Callie cuts in, now impressed because she thinks he's the one who actually saved the cop and Alex decides not to correct her. As they walk towards a bed she tells him that he's not what she pictured -- she figured he would be a dork who made good, but he's hot. Alex tries to flirt and asks if his skill in the elevator turned her on and she says no while she pulls the curtain back and we see Sunder and his legs from the photo as she finishes, "But this does."
Cristina has nodded off but Meredith nudges her to see the speaker, who is none other than Richard. Everyone is surprised and Derek and his perma-furrowed brow look a bit worried. His story is from the days back when he was a resident at Seattle Grace. He tells everyone that while they will learn from everyone while they are residents, they'll learn the most from each other. Back in 1982, the hospital was done up in shades of orange and yellow. The Chief is played by Hey! It's that Scumbag! Gregg Henry and Young Richard is played by J. August Richards, who most of us know as Gunn. HITS is overly chummy with one of the doctors because he plays golf with his father, and clearly this is a White Boys' Club. A nurse is wearing one of those pointy paper hats that makes me wonder if she just materialized from the '60s -- seriously, it doesn't seem right for her to be wearing that in 1982. They walk into a room to find a woman doctor yelling instructions, about to shock a patient, and when one of the docs tries to take over the paddles and calls her "Nurse," young Ellis Grey yells at him to back off and gives a smug smile when she brings the patient back. (Young Ellis is played by Sarah Paulson, and excellent choice who looks uncannily like a young Kate Burton and has Ellis' mannerisms down pat.)
Current-day Richard tells the assembled group that he was working with Ellis Grey, two-time Harper Avery award winner, and that this case changed his life. Mere raises her eyebrows, knowing that there's some heavy double meaning there. Cristina perks up and comments that this is going to get interesting and Mere agrees, then smiles, but then looks worried. I'm not quite sure which facial expression she was supposed to have but the fact that she portrayed both back to back unfortunately feels like some bad acting since it didn't make any sense.
He heaps some more praise on the late Dr. Grey, calling her a groundbreaker and one of the best doctors anyone has ever seen, but says that back when she was a resident she was called sugar, nurse, or just nothing. Back in 1982, HITS reminds the doctors that this patient, Phillip, came in for a hernia repair and orders them to figure out fast why his heart stopped. They all walk off, except for Richard and Ellis, and he tells her, "Looks like just you and me kid." Apparently this isn't a new thing; she snarks, "Surprise, surprise."
Callie has dropped her notecards and is whimpering like a puppy as she tries to gather them back up. For what was an overall pretty good episode, this part of the storyline made me actively angry, because it's just not Callie to completely lose her shit like this. I am speaking as someone who is generally personable but who also is absolutely terrified of public speaking, so I'm not trying to write off the fear as dumb or unrealistic. But someone as gregarious, opinionated and social as Callie wouldn't turn into a vomiting, whimpering, mumbling puddle like this. Sweaty? Talking too fast? Jittery? Reading from her cards and not making eye contact? Losing her train of thought? Anything like that I could understand, but turning completely inept just isn't believable and was totally distracting since it felt like yet again an unbelievable character trait was written in just for the sake of story. Arizona finally yells at her just to talk, and like a chastised child Callie agrees and starts mumbling, each sentence in the form of a question, about her patient who wanted his club foot fixed. She had another idea for him.
Richard screams at her, asking if she told him he'd be able to walk. She's confident that her time in the Peace Corps and her experience there with polio will help her out, but Richard takes her down a notch. He tells her that she grew up privileged, which made her arrogant -- a trait dangerous in a young surgeon. Alex watches as she assures Richard that she didn't make the promise lightly and can do it, but Richard just asks if she said she would try or if she said she could do it. She doesn't say anything, which gives Richard his answer, and so he agrees and threatens that her career is going to depend on this case.
Grey calls HITS an ass and continues to insult him while Richard more genially thinks out loud, baffled by the case. He manages to make her smile and they brainstorm as they walk down the hall, carefully slip into an on-call room, and start to make out and rip off each others' clothes. Richard comes up with an idea and jumps up, and despite Ellis' efforts to keep him there for some fun, he runs off to go investigate.
Bailey asks the audience for the most important step in the treatment process. To her disappointment, everyone calls out various answers that are wrong until Lexie answers "Patient history." She's pretty smug about it too.
Back in 2003, Mandy is trying to see Alicia's surgery over all of the taller doctors in the OR. Blondie has found gallstones but when she tells Richard that they are caused by fatty foods, Mandy tentatively calls out that Alicia is vegan. Blondie yells at her to shut up or leave, but Richard is intrigued and asks for more info, so Mandy reads from her notepad that Alicia had severe reflux until at 15 she became a vegan, and that her last boyfriend had been a vegan chef. Richard is impressed with her detailed patient history and tells Blondie that her intern is doing an awesome job. She seethes while Mandy nervously goes back to taking copious notes.
Once the surgery is over, Blondie walks up with a stack of charts a foot tall and threatens that if Mandy does that in front of the Chief again, she'll end her. She's so angry she's almost spitting -- I guess this was the hour that Grey's really wanted to make sure that all of the characters from before were hardcore caricatures. Mandy nods, clearly already tired of the anger, and Blondie dumps the charts on her to do scut for the foreseeable future.
Richard tells the group that since they aren't allowed to beat residents with sticks, they punish them with scut, and Bailey smiles at her recent memory. But, he tells them that while testing tissue samples was boring, it's how he and Ellis discovered that Phillip had some sort of crazy fungus.
They go to his room and ask him if he had been in a tropical country recently, or if he lived near a bird aviary or somewhere with lots of pigeons. His girlfriend, wearing a colorblock sweater straight out of Benetton, laughingly asks them what kind of questions these are. They ask her to step out, and current-day Richard explains that they needed her gone because they had to ask hard questions as they suspected that he had GRID. He asks the audience if they know what that is and Lexipedia answers, less smug this time, that it is AIDS. She's right, and Richard explains that in 1982 it was known as "Gay Related Immune Deficiency." Phillip hits the roof when he hears this, seemingly appalled that they would suggest he has sex with men. Despite the doctors trying to assure him that they aren't judging him, he jumps up in a rage and when Ellis pleads that he needs antibiotics, he yells that he'll get them elsewhere and he'll also be reporting the two of them to their superiors.
This episode is actually a pretty interesting history lesson -- Richard lectures that in early 1982 there were only five cases of GRID in San Francisco and none at all in Washington State, and that the government wasn't yet funding research since it was isolated to the gay community. When he asks, Cristina answers that they didn't discover the HIV virus until 1983 and didn't develop a test for it until 1985.
It was so new, no one knew how to handle it, least of all HITS. He's enraged that they accused a patient of having this and reminds them that no one has proven the disease actually exists, and that the patient isn't even gay. One of his residents smirks, but a couple of others are embarrassed and I'm willing to bet one isn't necessarily straight himself. Phillip is threatening to sue for slander, so HITS pus Ellis and Richard on probation.
Callie is now sucking down water from a water bottle so loudly it's squeaking with each swallow, and the crowd is starting to giggle. Arizona is nervous for her girlfriend but again, come on. Even nervous she'd be able to drink water quietly.
She's in surgery working on Sunder when the anesthesiologist warns that he's getting unstable. She shushes him and ignores his warning to wrap things up, insisting she just got started. Alex reminds her she started eight hours ago, but she says she's just being thorough. She seems to be trying to convince herself as she says is pretty sure this will work, but the anesthesiologist continues to try to get her to stop. Alarms finally start to ring, and Alex asks Callie if she wants him to walk or live.
Bailey asks the doctors if you learn more from successes or failures. As only people we know answer questions, Avery says failures and earns a chocolate, but she tells him that was an easy question. Alicia was back in the hospital three months later with more pain, and her symptoms indicated appendicitis. Mandy diagnosed her and Richard gave her the appendectomy as her first solo surgery.
Alicia is really nervous, but Mandy assures her it will be okay and once in surgery, Richard compliments her skills. He tells her he was glad she decided to come to Seattle Grace as she was a strong applicant, and she goes from happy to nervous as she glances up to see Blondie boring angry lasers down at her from the gallery. Richard sees it too, and tells her that this is a shark tank, and to "Make sure you're a shark too and not a minnow." She thinks this is a crack about her height but he tells her it's about her being quiet -- he then points out that she's about to remove a healthy appendix. Mandy is devastated but Richard assures her that this happens and to shake it off. She's going to have a hard time, though, with Blondie gloating and holding it over her head as she seems to already be doing from above.
Callie is STILL mumbling as she says she didn't want to close but she had to. Arizona is worried when she sees how frightfully bored the crowd has become and when Callie loses her train of thought, Arizona turns and tells Alex to help her out since he was there. Alex calls out, "That's when we saw the dude do the thing with his foot." It's a whole lot of extra words to say that Sunder wiggled his toes.
Callie and Alex are in Sunder's room after the surgery and she tells him that it was more difficult than anticipated because his heart and lungs couldn't handle the anesthesia. He's got a crazy halo around his ankle and pins holding everything in place, but he's in a perfectly cheerful mood and assures them he understands, then asks when she's going to go back in. He doesn't understand that she is trying to tell him that it's not going to happen and pleads, wiggling his toes for the first time since he was a kid. He pleads that he has always been stared at and just wants to stand up straight and walk, and he thinks that she can do that for him and begs her to try.
Richard tells everyone that while surgeons hate giving up, he and Ellis were a magical dream team who hated it more than everyone else. However, when a patient refuses treatment, a surgeon is done and that's what they thought. Obviously leaving that hanging means that this wasn't going to remain the case...
Ellis walks up to Richard and they flirt, making plans for an on-call room liaison shortly. However, nothing ruins a sexy moment like a toddler, especially when she's yours, and Ellis is obviously ticked off when a young Thatcher with a rather spectacular, if disheveled, head of curls comes in with Meredith, who is holding Anatomy Jane. Nice touch there, GA. She angrily reminds Thatcher that the doll was for Mere's birthday, but Thatcher is already proving to be inept and says that she was crying for Ellis and he got desperate. The men say hi to each other, and Richard is clearly uncomfortable though he tries to cover it up. Ellis leans down to give Mere a precious couple of moments but the two docs are then paged on the intercom and leave. Meredith grabs Ellis' leg and pleads with her not to go, but Ellis peels her off and yells at Thatcher to take her -- always multitasking, that one. She marches off and Richard gives a guilty look back over his shoulder at Ellis' pathetic, sad little family, even though she is completely unbothered by it all.
They find the doctors all standing outside a room and HITS has a mask to his face as he spits that their GRID patient is back. We can see him inside, and he has sores on his face and is staring blankly away from the gaping crowd. HITS orders them to handle it and when they go inside, Phillip slowly lowers his mask and apologizes, saying they were right about everything. Ellis looks more worried about him than she did about her own family, and he begs the doctors to help him.
Back in present day, Bailey has the whole crowd interested because no one can figure out what is wrong with Alicia. Everyone shouts ideas of what tests to run, and each idea earns a chocolate. Bailey tells them all that sometimes a doctor must be a patient's advocate and push to get things done.
Mandy seeks out Blondie to ask about her decision to discharge Alicia with only a note for a psych consult. Blondie spits that Alicia is clearly just trying to get pain meds and is depressed, and Mandy counters that months of severe untreated pain would in fact depress a person. She suggests a few different tests -- the ones that were suggested during her lecture -- but Blondie is sure she knows it all and says she won't order expensive tests for something Prozac could cure. Richard then comes up and asks what's going on with Alicia but since he's the Chief, Blondie is a little more deferential when she says that she is just depressed, and when Richard also points out that having three unnecessary surgeries would do that, she suggests the very tests she just mocked Mandy for requesting. Mandy is one pissed minnow, while Richard compliments Blondie's thinking.
Ellis and Richard are looking at Phillip's scans and he's got something only ever seen in children. They talk about how they might treat it, and then Richard asks HITS for his opinion. The young docs are surprised when he says he wouldn't operate and calls the guy a lost cause with GRID. Ellis icily informs him that it's now called AIDS but HITS isn't concerned with pesky things like actual disease names -- he reminds them that they don't know how the disease is spread, and he declares that he won't risk the lives of his staff for someone who isn't going to live. He refuses to operate and recommends they don't either. Poor Phillip's skin is now a sickly grey, and his sores are growing. Richard angrily reminds HITS that they took and oath but HITS turns and sneers at him that ten years before neither he nor Ellis would have been allowed in the program, so don't tell him about his oath. I guess this is equal opportunity, that each person's story has one especially over-the-top element.
Callie is now relying on Alex, and he reminds her that they planned to do a number of surgeries for Sunder. She still can't remember what comes and so he then prompts that he gave her a rousing pep talk. Everyone laughs, but she admits that he did, and for the first time all day we see a glimmer of normal Callie.
On the bridge, that mystical place where all pep talks are held, Alex is trying to convince Callie to go through with it as she's having major doubts. He asks what would have happened if he froze in the elevator? He had every reason to freeze (and in reality, totally did) but she says he didn't and Alex gives a blow-by-blow of what George did as if it was him -- he cut the guy open and stuck his finger on the hole to stop the bleeding. He encourages her to pretend she's in an elevator in a blackout, and it seems to work.
Meredith asks what the results were, but she's not talking about Callie, she's back to Bailey, who says all of the results were negative. At her wit's end, she did what she always tells her students to do and hit the books, if by "books" you mean "booze."
The pile of umbrellas to her pink fruity cocktail show that she's a few in already, and drunkenly complains to Joe about how she was raised to be polite. Joe's memo had a typo -- his hair is more 1993 than 2003 with its long curls. Mandy gripes about how she was raised to respect her bosses and not to be a shark -- as she swirls her drink we can see her engagement ring. Joe clearly feels terrible for her, but he might also be mourning the state of his hair. And Mandy's clothes! She's got a denim vest on over a sweater, which I don't recall ever seeing just seven years ago. Come ON, people.
Current-day Richard tells the crowd that he and Ellis weren't noble, they were arrogant and had more to prove. 1983 Richard and Ellis tell Phillip about some terrible things going on with his bowel, but Ellis tells him that they can operate. Phillip asks if HITS is going to do it and the two have to admit that he's stuck with just them; Phillip knows everyone else is scared especially as they are all standing outside his room, staring in and whispering all day and asks if Ellis and Richard are too. (Hatwatch 1983: Nurses are still wearing pointy paper hats.) Richard draws the curtains so that no one else can see in as Ellis declares, "Screw them," but Phillip begins to cry scared tears. He wants to hate everyone for being scared but wonders how he can when he's the one who has been living a lie. The statement doesn't actually make much sense from a to b, but the tone is there -- he's terrified, he's angry, he feels guilty for being angry. Richard looks ashamed because of course he's living his own lie, but Ellis just tries to pep talk him into the surgery. He asks why bother if there is no cure, but Richard snaps out of his own guilty haze and says that there could be a cure tomorrow, and asks him again to let them operate.
Callie is now giving her "lecture" from the edge of the stage, like she's having a conversation with a few friends. It's working for her though, and she's much more herself as she talks about how they researched and practiced and were eventually ready to go.
Surgery isn't going as planned, though -- Sunder's vitals are dropping and she realizes he's had some sort of massive cardio problem. She yells for someone to page cardio but tells Alex that they don't have time, and have to drain the blood around his heart. She tells him it's just like what he did in the elevator and orders him to take the scalpel. Alex freezes once again and says he can't, and when Callie yells that he already did it once, he fesses up that it wasn't actually him in the elevator. It's clearly not what she wanted to hear and her eyes get panicky.
After a second, though, she pulls herself together and says that he's doing it anyway -- just because he hasn't doesn't mean he can't. She orders him to pull himself together and take the scalpel and finally he does and after a moment talking himself through the procedure, goes ahead and does it. Here's my question, though -- if Callie knows just what needs to be done, why doesn't she just do it?
Richard reminds the audience that he and Ellis knew this was risky; now we know that the virus is transferred by exchange of bodily fluids but back then they had no idea and so it could have been anything.
He and Ellis are going for it, though, and Ellis richly comments about the poor guy living a lie for so long, calling it a shame. Richard can't let this one go and points out that they are living a lie too. Since Ellis' world is just dictated by what she wants for herself at any given moment, she asks what. When Richard says they have to stop what they are doing, Ellis angrily declares that their marriages are the lie and their relationship is what is real. She's totally determined as she declares that they should each leave their spouses, but Richard tells her he can't and then reminds her of the small matter of her daughter. She goes to walk into the OR but Richard calls after her that he can do the surgery since she has Meredith to think about. Not having really absorbed anything of what he just said, beyond the fact that she didn't like it, she turns on him and says that despite his different skin color he's just like the rest of them. Angrily she tells him that she had a daughter but that doesn't make her inept or less of a woman or surgeon, "No matter how much everyone wants it to." I suppose that chip on her shoulder helped her get to where she ended up, but it's obvious that even before the Alzheimer's she only selectively listened to people with whom she was having a conversation -- nowhere in Richard's desperate guilty suggestion did I hear a whiff of him calling her less of a woman.
Bailey picks up her story, telling the doctors that her "research" didn't help, so Blondie sent Alicia home and Bailey thought she won. A couple of months, afterward, however, Mandy is walking down the hall and sees Alicia back again. She is relieved to see Mandy and explains that they think she might have an obstruction and want to go back in to check it out. Mandy looks at her chart and Alicia cries pitifully that she's not sure she can take it and wants Mandy to promise that this surgery will finally help. Mandy doesn't hear her because she notices the urine from the catheter is dark. When two guys walk in to take her to surgery, Mandy throws her tiny self in front of them and forbids them to touch Alicia just yet.
Lexie asks present-day Bailey if it wasn't bold to cancel her resident's surgery -- and while I think Missi Pyle played Blondie so angry it was comical, I do think that any one of the residents we know and love would kill any intern who so much as thought about doing that to them. Bailey says it was stupid, not bold, but it was necessary.
Blondie comes up to her and demands to know why she cancelled the surgery, and with her crazy eyes blazing reminds Mandy that she answers to Blondie, and that as surgeons what they do is cut. She orders someone to rebook Alicia's surgery but Mandy jumps in and says just because they are surgeons doesn't mean they shouldn't look for another cause. She chastises Blondie, saying if she'd looked into it further and talked to the patient she'd have noticed all sorts of other symptoms, and asks if they ring any bells. Blondie now looks psychotic as she says no and so Mandy announces that she has suchandsuch disease. Mandy basically just did a classic Villain Monologue, describing each step of the way for our sakes when in reality it would have made more sense to spit out the disease name first and then go from there. But this was very, very dramatic. Mandy is on a roll and chastises Blondie for taking out Alicia's ovaries and gallbladder, and though she takes responsibility for taking out her healthy appendix she tells Blondie that she learned from that -- learned not to cut. She then asks how Blondie hasn't learned this yet in three years when Mandy learned it in three months? Richard has walked up and is listening to the tirade, but does try to break in after a moment. Mandy continues to lecture Blondie and talks about the medicine Alicia needs, and doesn't seem to even hear Richard. When she yells at Blondie that she is a "supercilious fool," though, Richard yells at her to meet in his office. Mandy is crying, and shakes her head, sure she's totally busted.
Callie, still sitting on the stage, tells the crowd that they wound up doing a bunch of shorter surgeries that Sunder's body could handle, and while it was hard on him it was worth it in the end. Alex tells her to show the x-rays, and she jumps up in happy surprise, as if she would have forgotten to show off her end product like that. The before picture is of a leg and foot curled up, while the after shows a leg and foot that are straight and pointing in the right direction. The awed crowd gives her a big round of applause, and Callie laughs, happy and fully herself. She says that it was amazing and that afterwards they celebrated, "Man, did we ever celebrate." We see that she and Alex celebrated with their clothes off in her secret basement bedroom after she swears him to silence, but Arizona clearly guesses what Callie meant and turns to give Alex a questioning look. He's good, though, and keeps a total poker face.
Mandy is sitting in Richard's office while Blondie and her friends watch from outside, laughing at her. Seriously, these windows were the most ridiculous idea ever. Did no one think that private meetings might sometimes be in order? He informs her that his job is to make sure his residents are treated with respect, and Mandy immediately apologizes. Richard tells her, scowling, that she's said enough for one day, and it's his job, "So we're going to sit here, with you wearing that terrified look on your face for a respectable amount of time, so that [Blondie] and her friends can assume you're having your behind handed to you on a platter." She is speechless, and he adds that she's going to be an incredible doctor. When she smiles, he reminds her sternly to lose the smile and she does. Here's my question -- what happened to Blondie and all her friends, then? Presumably this took place not long before the series started, so wouldn't Blondie still be there? Or wouldn't some of those other residents, at least? Which would make this lecture that portrays her as a buffoon kind of inappropriate? I actually really liked seeing the beginning of Bailey's career and think the story was great, but that part doesn't quite add up.
Richard then tells the crowd that while Phillip survived the surgery, he died eight months later of pneumonia. He opts not to speak for Ellis but says that personally that's when he stopped feeling like a superhero and thought about how dangerous this is, reminding them all that the work, as well as one's patients and colleagues, changes them. He reminds them that they can lose their way and to remember why they came here, to remember the oath they took after med school. As the episode-ending music starts up, he raises his hand and, matching the speech he made at the beginning of the episode, begins the oath again. "I solemnly pledge to consecrate my life to the service of humanity." Derek sits up -- he might do well to find a second facial expression other than merely knitting his brow. He repeats the oath as the doctors watch solemnly. Cristina mimes the words as he speaks them, and Bailey smiles proudly. When she turns around she sees Dr. Warren watching her, and smiles shyly as he gives her some silent applause for her lecture. Callie turns to Alex with her own quick, "let's continue to not talk about how I've now been shown to have slept with half the men on this show," look.
Her promise to Sunder was realized -- he is walking slowly with crutches down the hospital hallway, beaming, and Richard puts a hand on Callie's shoulder to congratulate her on her job.
In 2003, he sees Blondie giving Alicia her medicine while Bailey chats with her very happy patient.
Twenty years earlier, Ellis takes Phillip's hand as he's clearly at the end of his life. Richard takes his other hand, and as Phillip looks up at them they also take each other's hands and look at each other. Phillip takes one last shaky breath, and then leaves this mortal coil.
Current-day Richard is still reciting the oath while everyone watches seriously. When he finishes, everyone applauds warmly and gives him a standing ovation. Derek looks around at everyone beaming down at their former boss; Bailey has tears in her eyes for him. Richard quietly walks off the stage.
Later, he's sitting in the lobby when Derek and Mere come by on their way home. He looks wary as they both smile at him, but Derek just says that the job offer still stands, and to think about it and let him know. Mere gives him one more warm smile, and the two hold hands and leave. Once out of earshot, Richard answers, "We'll see."
He's got a lot to think about -- like how the case that changed him didn't just change him as a doctor. At the bar, pre-Joe, Ellis lifts a drink and toasts Phillip, and Richard raises his Coke to that. Ellis snottily tells him that he can't toast a dead Irishman with a soda, and tells the bartender to give him a vodka. He admits he can't stand the taste but Ellis orders, "It's time to learn. You're a grown-up, Richard. It's time to act like it." He just stares at the drink and then admits he can't leave Adele, but Ellis just nods and answers, "We'll see." She takes a sip of her drink and after a moment, Richard tries his own and grimaces at the taste. And there we have it -- the brilliant Ellis Grey unwittingly, but due to her own selfish ways, helped start Richard down his road to alcoholism.
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